Unquiet Mind of Bipolar Disorder
Depression in bipolar disorder is conventionally associated with melancholy, where the patients exhibit retardation of mental and physical activities and remain indifferent to any happy situation. However, recent findings, which indicate that people with bipolar disorder ruminate in both depressed and manic moods, contradict this fact, as the tendency to ruminate involves high mental activity.
Rumination, in both bipolar disorder and major depressive disorder, is a way of responding to depression wherein the affected person repeatedly analyses the cause and outcomes of the distress and develops a negative opinion about oneself leading to low self-esteem.
The distinguishing factor of bipolar disorder type II mental illness is that the patients, while in hypomanic mood, ruminate in a positive manner with an elevated self-confidence and focus on their lifetime goals, in response to positive feelings.
The experts opine that the tendency to ruminate in response to positive experiences might be to sustain the good feel the persons get by focusing on their goals and achievements.
Though there are inconsistencies in terms of structural abnormalities of the brain in bipolar disorder, studies seem to agree that functional disturbances of the brain exist in patients with bipolar disorder. Experts feel that rumination in bipolar disorder is due to executive dysfunction, i.e. inability to coordinate physical movements or mental thoughts. Many areas of the brain associated with bipolar disorder appear to overlap with the areas involved in rumination. The authors call for a deeper probe into the neural mechanism of rumination in bipolar disorder to find the consequences of both positive and negative rumination.
Reference: Rumination in Bipolar Disorder: Evidence for an Unquiet Mind; Sharmin et al; Biology of Mood and Anxiety Disorders 2012